The Spinal Cord Basic Neuroscience James H. Baños, Ph.D. Grey and White Matter Grey and White Matter Grey Matter = Cell Body White Matter = Myelinated axon Grey and White Matter Grey matter Cortex Nucleus (CNS) Ganglion (PNS) Exception: Basal Ganglia Grey and White Matter White Matter Nerve (PNS) Tract (CNS) Fasciculus/Funiculus -- Group of fibers with common origin and destination Lemniscus -- Ribbon-like fiber tract Peduncle -- Massive group of fibers -- usually several tracts Grey and White Matter Tracts are named with origin first, then destination Corticospinal tract -- cortex to spinal cord Mammilothalamic tract -- Mammilary bodies to thalamus Spinocerebellar tract -- Spinal cord to cerebellum Corticobulbar tract -- Cortex to brain stem The Spinal Cord General Organization Spinal cord is SMALL! 42-45 cm long 1 CM wide at widest point Does not extend all the way to the bottom of the spinal column Pattern of grey/white matter is reversed in the cord White matter tracts on outside Grey matter on the inside Staining reverses this!!! General Organization White matter (tracts of axons) Grey Matter (cell bodies) General Organization Spinal cord is segmented anatomically Input and output occurs in groups of rootlets arranged in a series longitudinally along the cord Dorsal rootlets -- Input -- carry sensory information Ventral rootlets -- Output -- motor neurons General Organization Each set of rootlets forms a spinal nerve that innervates a corresponding segment of the body, called a dermatome General Organization General Organization There are 31 segments in the spinal cord: 8 cervical (C1 - C8) 12 Thoracic (T1 - T12) 5 Lumbar (L1 - L5) 5 Sacral (S1 - S5) 1 Coccygeal General Organization The spinal cord is housed within the vertebral column General Organization Each cord segment has a corresponding vertebra of the same name (e.g., C3) Spinal nerves enter/exit underneath their corresponding vertebral segment General Organization But wait! Something doesn’t add up! How can spinal nerves exit below their corresponding vertebral segment if the cord is only 42cm-45cm long? Answer: Spinal nerves extend down to the appropriate vertebral segment forming the cauda equina This means cord segments and vertebral segments don’t line up General Organization General Organization Cord is not of uniform thickness throughout its length. Why not? General Organization Cord is not of uniform thickness throughout its length. Why not? Answer: Segments of the cord innervate parts of the body that differ in complexity There are fewer white matter tracts lower in the cord. General Organization Cervical enlargement C5 - T1 Lumbar enlargement L2 - S3 The Spinal Cord in Cross Section Cord Sections Segments of the spinal cord have a similar organization, but vary in appearance. Always know where you are in the cord (i.e., cervical, thoracic, lumbar, sacral) Cord Sections -- Cervical Cervical cord is wide, flat, almost oval in appearance. Why? Cord Sections -- Cervical Enlargement What’s different about the cervical enlargement . Why? Cervical Cervical Enlargement Cord Section -- Thoracic Less White matter than cervical Rounder appearance Less prominent ventral horns than cervical enlargement Cord Section -- Lumbar Lumbar Lumbar Enlargement Less White matter than thoracic Rounder appearance Larger ventral horns, especially in lumbar enlargement Cord Section -- Sacral Not much white matter Mostly grey, although not much of that either Cross Sectional Organization Posterior intermediate sulcus Posterior median sulcus Tract of Lissauer Anterior white commisure Anterior median fissure Grey Matter Laminar Laminae of Rexed Grey Matter Posterior (dorsal) Horn Intermediate Grey Anterior (ventral) Horn Grey Matter: Posterior Horn Mostly Interneurons Substantia gelatinosa Pain/temp proc Body of the posterior horn Sensory proc Grey Matter: Intermediate Grey Clarke’s Column T1-L3 Balance/proprio. Intermediolateral Column T1-L3 Sympathetic neurons Grey Matter: Anterior Horn Lower Motor Neurons White Matter: The “Big Four” Pathways Corticospinal tract Dorsal Columns Spinothalamic tract Spinocerebellar tracts The Big Four Corticospinal tract Dorsal columns/ medial lemniscus Discriminative touch Conscious proprioception Spinocerebellar tract (dorsal and ventral) Voluntary motor Unconscious proprioception Spinothalamic tract Pain/temperature Corticospinal Tract Voluntary Motor Corticospinal Tract First order neuron (upper motor neuron) originates in precentral gyrus Passes through internal capsule 90% decussates in caudal medulla 10% undecussated Lateral corticospinal tract Anterior corticospinal tract Synapses on second order neuron (lower motor neuron) in ventral gray of the cord Second order neuron innervates muscle Motor Homunculus QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. HAL Motor Homonculus HAL: Arms Head QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. Legs QuickTime™ and a Microsoft Video 1 decompressor are needed to see this picture. Corticospinal Tract Spinal Cord Medulla Pons Midbrain Upper & Lower Motor Neurons Motor Ctx Upper Motor Neuron UMN Lower Motor Neuron Ventral Grey Horn Ventral Grey Horn to Neuromuscular Junction Efferent of stretch reflex arc Helps maintain tone Sensory Neuron LMN Motor Cortex to Ventral Grey Horn Modulatory influence on stretch reflex arc Stretch receptors in muscle and tendons Helps maintain tone Afferent of basic stretch reflex arc Upper & Lower Motor Neurons UMN LMN Maintenance of Tone Input from stretch receptors causes lower motor neuron to supply tonic stimulation to the muscle The upper motor neuron modulates this -- will tend to “override” the tonic signal from the sensory neuron Upper & Lower Motor Neurons UMN LMN Reflex Arc Afferent is sensory neuron detecting a sudden stretch Signal is strong and results in a strong response by the lower motor neuron Strong signal usually overcomes mild cortical input from the UMN Upper & Lower Motor Neurons Motor Ctx Upper Motor Neuron Signs UMN Ventral Grey Horn Why? LMN Spastic paresis Hypertonia Hyperreflexia No muscle atrophy (until perhaps late in the course) Positive Babinski Loss of voluntary UMN signal Loss of modulation of tone and reflexes by UMN -- the circuit runs unchecked Upper & Lower Motor Neurons Motor Ctx Lower Motor Neuron Signs UMN Ventral Grey Horn Why? LMN Flaccid paresis/paralysis Muscle fasciculations Hypotonia Hyporeflexia Muscle atrophy Negative Babinski Loss of LMN for voluntary movement Loss of efferent component of reflex arc and tone pathway Babinski’s Sign In response to stimulation of the sole of the foot, the toes will usually curl downward. When UMN inhibition is removed, the toes will curl upward (Dorsiflexion). This is referred to as a positive Babinski or presence of Babinski’s sign. Related Terms… Spasticity -- Increased muscle tone and increased reflex contraction (UMN) Clonus -- Rythmic contractions and relaxations seen when a spastic muscle is stretched (UMN) Basics of Localization If all limbs are checked for upper and lower motor neuron signs, you can begin to localize lesions Left-right differences are also very important Dorsal Column/ Medial Lemniscus Discriminative Touch Conscious Proprioception Dorsal Columns/Medial Lemniscus First order neuron begins in receptor Enters cord at tract of Lissauer Legs run in fasciculus gracilis (medial dorsal) Arms run in fasciculus cuneatus (lateral dorsal) Synapse on nucleus gracilis and nucleus cuneatus (caudal medulla) 2nd order neuron decussates and runs from NG & NC to thalamus (as medial lemniscus) 3rd order neuron runs from thalamus to postcentral gyrus Dorsal Columns/Medial Lemniscus Spinal Cord Medulla Pons Midbrain Spinocerebellar Tracts Unconscious Proprioception Dorsal (Posterior) Spinocerebellar Tract Involves Clark’s Column, a longitudinal gray matter body from about T1 to L3 Below Clark’s Column: Level of Clark’s Column Runs with f. cuneatus, synapses in Clark’s Column, joins dorsal spinocerebellar tract Synapses in Clark’s Column, joins dorsal spinocerebellar tract Above Clark’s Column Runs with f. cuneatus, synapses in lateral cuneate nucleus (caudal medulla), projects to ipsilateral cerebellum Dorsal (Posterior) Spinocerebellar Tract L3 Spinal Cord T1 Medulla Pons To Cerebellum Midbrain Ventral (Anterior) Spinocerebellar Tract Supplements Dorsal Spinocerebellar Tract Information from more diverse array or receptors Originates from scattered cells in the intermediate grey caudal to L1 (which in turn have input from proprioceptive axons or their collaterals Crosses twice, to end up in ipsilateral cerebellum Ventral (Anterior) Spinocerebellar Tract Spinal Cord Medulla Pons Midbrain Spinothalamic Tract Pain and Temperature Spinothalamic Tract First order neurons originate in pain receptors, enter cord at tract of Lissauer, and synapse in substantia gelatinosa or nucleus proprius Second order neurons cross at the anterior white commissure, rising 1 or 2 cord levels in the process, and form contralateral spinothalamic tract A third order neuron (not technically spinothalamic tract) projects to the cortex Spinothalamic Tract Spinothalamic Tract Spinal Cord Medulla Pons Midbrain L1 L1 L2 L2 L3 L3 L4 L4 L5 L5 Coming Up… Lab Week Overview: Monday Virtual Labs Wet lab day: Thursday Lab Practical Exam: Friday